Efficacy of Antidepressants and USPSTF Guidelines for Depression Screening
Authors: Evelyn P. Whitlock
Journal: Annals of Internal Medicine (2010)

Letters1 June 2010Efficacy of Antidepressants and USPSTF Guidelines for Depression ScreeningEvelyn P. Whitlock, MD, MPH, Elizabeth A. O'Connor, PhD, and Bradley N. Gaynes, MD, MPHEvelyn P. Whitlock, MD, MPHFrom Oregon Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, OR 97227, and University of North Carolina School of Medicine, Chapel Hill, NC 27599.Search for more papers by this author, Elizabeth A. O'Connor, PhDFrom Oregon Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, OR 97227, and University of North Carolina School of Medicine, Chapel Hill, NC 27599.Search for more papers by this author, and Bradley N. Gaynes, MD, MPHFrom Oregon Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, OR 97227, and University of North Carolina School of Medicine, Chapel Hill, NC 27599.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-11-201006010-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree that trade-offs may be involved in conducting targeted systematic reviews to efficiently update an evidence-based recommendation. We refer the reader to the USPSTF's procedure manual (1) for further clarification on their rationale and approach for conducting updates.Dr. Poses suggests that explicit inclusion of unpublished trials in meta-analysis would reduce current estimates of antidepressant efficacy, thus undermining the rationale for depression screening in primary care. We do not believe an overestimate has been clearly established, and if it was, there are several reasons why it would not undermine the importance of screening. First and foremost, the ...References1. U.S. Preventive Services Task Force Procedure Manual. AHRQ Publication No. 08-05118-EF. Rockville, MD: Agency for Healthcare Research and Quality; 2008. Accessed at www.ahrq.gov/clinic/uspstf08/methods/procmanual.htm on 16 March 2010. Google Scholar2. Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R. Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med. 2008;358:252-60. [PMID: 18199864] CrossrefMedlineGoogle Scholar3. Kirsch I, Moore TJ, Scoboria A, Nicholls SS. The emperor's new drugs: an analysis of antidepressant medication data submitted to the U.S. Food and Drug Administration. Prev Treat. 2002; volume 5: article 23. Google Scholar Author, Article, and Disclosure InformationAuthors: Evelyn P. Whitlock, MD, MPH; Elizabeth A. O'Connor, PhD; Bradley N. Gaynes, MD, MPHAffiliations: From Oregon Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, OR 97227, and University of North Carolina School of Medicine, Chapel Hill, NC 27599.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for Depression in Adult Patients in Primary Care Settings: A Systematic Evidence Review Elizabeth A. O'Connor , Evelyn P. Whitlock , Tracy L. Beil , and Bradley N. Gaynes Efficacy of Antidepressants and USPSTF Guidelines for Depression Screening Roy M. Poses Metrics Cited byTime trends of antidepressant drug prescriptions in men versus women in a geographically defined US population 1 June 2010Volume 152, Issue 11Page: 753-754KeywordsAntidepressantsConflicts of interestDrugsMajor depressive disorderScreening guidelinesSystematic reviews ePublished: 1 June 2010 Issue Published: 1 June 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...